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The Wide World of Botox and Fillers: What You Need to Know

March 29, 2019

To Botox or not to Botox? That is the question. I’m pretty sure that’s the true nature of the phrase Shakespeare intended. Or at least it would have been if he had found himself aging in the 21st century.

I want to begin this post with two truths (at least according to me). The first: no one truly needs Botox or fillers or any type of anti-aging treatment. The ability to age means we have the ability to live, and that right there is a beautiful thing. This post is in no way trying to tell women that they need to go out and fix something about themselves. Because they don’t.

And the second: whether you currently receive Botox or filler treatments, are curious and may want to start those treatments, or never want a needle to touch your face, then more power to you! Another beautiful thing about the aging process is that we get to decide how we want to handle it. And there is no right or wrong answer. So, girl, you do you.

I also want to make it clear that Allergan (the maker of Botox and Juvederm) did not sponsor this post, however I did receive complimentary treatments to try out both Botox and Juvederm (a filler). Based on my experiences I chose to write this blog post and all opinions are completely my own.

Okay, here we go…

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WHEN IS THE RIGHT TIME TO START BOTOX?

There is no black and white answer to this question. As Dr. Dendy Engelman of Manhattan Dermatology and Cosmetic Surgery told me, “I never put an age with timing. It’s more what your face is telling you”.

Dr. Engleman says that over the last several years she has begun to see an influx of women in their 20s showing up in her office wanting preventative Botox. These treatments are becoming luxury items for which women will save up because they believe they’re making an investment in their skin that will pay off for years to come.

Why would someone want to start Botox that young? First off, everyone’s skin is different and some women in their 20s may already begin to see wrinkles and fine lines. But even if they are subtle, beginning treatments early can help prevent new lines from developing or deepening.

“If we can head that off at the pass and hope to release those muscles so that they’re not as strong, that helps soften the lines and we can stay in the very youthful looking state for much longer,” Dr. Engelman explained.

Of course, many women opt to begin treatments once they are older and are seeing more fine lines and wrinkles appear. Or, if you’re like me, when you go through a crazy stressful year and happen to catch a peak at yourself in the mirror of H&M one day and do a double take like, ummm who is that exhausted old woman? Where did all of those lines on my forehead come from?? Clearly this has to be a problem with the fluorescent lighting in here! Spoiler alert: it was not.

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HOW MUCH BOTOX IS TOO MUCH BOTOX?

There is an outdated perception that Botox is like a mask, freezing your face and rendering you eternally expression-less. I know when I first started hearing about these treatments around 20 years ago, I always associated it with losing the ability to physically show any emotion. And the only people who actually got it were extremely vain women who wanted to change their appearances.

Well, that was then.

These days you can get as much or as little of the treatment as you want, depending on the outcome you want to achieve. For many women (myself included) I simply wanted to soften the lines that had begun creeping onto my forehead and around my eyes. I didn’t want them to vanish and I didn’t want it to look like I ever “had work done”. But was something this subtle even an option?

The short answer is, hell yes.

When I first showed up at an Allergan Botox event back in January the first thing I noticed was that the women who worked for the company all had a glow about them regardless of their various ages. I would never have looked at any of them on the street and thought, oh yeah, that woman has had work done. Instead they just looked refreshed, well rested, and like the best version of themselves.

And most of them simply received a small Botox treatment a few times each year. Now that is the type of aging I could get behind!

The important thing to remember with Botox is that you can always get more. If you start small and see how it affects your fine lines you can always decide to add a little more. A good dermatologist will walk you through this process and employ the “less is more” mentality for first timers.

Dr. Engelman summed it up well when she said, “it’s fine if you want to tell your girlfriends your secrets but I don’t want you to have to”.

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HOW DO I FIND THE RIGHT DOCTOR?

The most important rule to follow when you are looking for the right dermatologist is this: a deal isn’t always a deal.

“Don’t Groupon your face,” says Dr. Engelman.

I know we all love a deal (myself included) but treatments for your face and body should not be compromised. I see deals for Botox and fillers at places like Groupon and Living Social all the time. But do yourself a favor and WALK AWAY FROM THE COUPON. It’s just not worth it.

Some people may think that Botox is Botox. And it is. But the people injecting it into your face are not all created equal. You’re going to want a good one for this.

Dr. Engelman says that all too often she ends up doing corrective treatments on women who opted for cheaper and ended up paying the price. Literally and figuratively.

The next rule is to do your research. Make sure the dermatologist is board certified. Look for before and after shots of their work to see if the aesthetic matches your own. Pay attention to the staff at a doctor’s office because they are likely getting treatments done by that doctor. It’s a good indication of what you can expect if you choose that dermatologist.

And set up a consult before you decide what you want to have done. Dr. Engelman says it should be a partnership between you and the doctor. Don’t let anyone talk you into a treatment. Make sure you are comfortable with the doctor and ask plenty of questions. If anything doesn’t feel right, then go find a different dermatologist.

This is your face we’re talking about here, people. Treat it well.

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WHAT IS THE DIFFERENCE BETWEEN BOTOX AND FILLERS?

Botox is a saline solution that is injected into certain areas to temporarily soften fine lines and wrinkles. It is most commonly used to smooth forehead lines, frown lines, and the crow’s feet. Once injected it takes up to seven days for the Botox to settle and take full effect. So, if you get home after a treatment and don’t see any change, hold off on panicking just yet! You will slowly start to see a difference.

Botox typically lasts 3-4 months, but I also know of some people who just receive the treatment twice a year. Once again, it’s totally up to you.

Fillers such as Juvederm are a gel that is also injected into the face to correct a loss of volume in the skin. Basically, as we age skin begins to sag and a filler will help plump it back up. It is typically used in the cheeks, the parenthesis lines around the mouth and the lips.

Because it is a gel while Botox is a saline, it requires a bigger needle and can be a bit more painful. This is why your dermatologist will likely numb the area before beginning the treatment.

Fillers will last up to two years.

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WHAT WAS MY EXPERIENCE LIKE?

Well, long story short, I am definitely a convert! Of course, it helps to have been set up with a great dermatologist who listened to my concerns and explained every step in the process.

I saw Dr. Engelman twice. Because it was my first time getting Botox we started small. At my first appointment she gave me a couple injections in the crow’s feet area and then a few along my forehead. She told me to give it a week and if I felt I needed more, then I could come back for a follow up.

The injections were not very painful, but there was some discomfort. After all, a needle is being stuck into your face. We’re not supposed to enjoy it. But the entire process took under two minutes and just as I started to think, “this might hurt”, it was over.

I experienced some redness at the injection spots, and you could see the little needle prick mark, but both went away after an hour or so.

At our first appointment I also told her about the concerns I had under my eyes in what’s known as the tear tracks, or tear troughs. Every time I looked in the mirror it was always the first thing I saw, a line that seemed to split my cheek. Most people I would talk to about it said I was crazy, and they had never noticed anything like that at all. But I knew it was there and it made me uncomfortable.

Dr. Engelman said that was a super easy fix and with just a couple small injections of Juvederm it would make a difference. If I decided I wanted the filler then we could do that at my follow up as well.

I then went home and proceeded to stare at my forehead in the mirror for the next seven days. Sure enough, as the week moved along, I started to see a subtle softening of the lines. Marc said he couldn’t tell that anything had happened, but I could see the difference and I loved it. And the fact that my husband couldn’t tell I had received any treatments made me love it even more.

But I did see a few areas where I felt we could go a tiny bit heavier with the treatment, so I made that follow up appointment. Due to crazy schedules I met with Dr. Engelman again about two months later. I told her the areas where I thought we could use a little more Botox and she agreed. But again, it would be just a small amount. I was going for that “fresh from a spa weekend where I slept nine hours every night” look, not the “face that used to be Laura” look.

As for the filler, first they applied a gel to my cheeks that would numb the area. That part of my face felt a little weird for the next few hours but wasn’t an issue at all. The numbing gel took about 40 minutes to take effect, so I just hung out, checking my email and Instagram in the exam room until it was ready to go.

While the Botox was relatively painless, the Juvederm was more uncomfortable. I have a high(ish) tolerance for pain, so I didn’t think it was too bad, but you will definitely notice a difference between the Botox and filler injections. But, again, the entire process is so quick that while it may be somewhat painful during the injection, it doesn’t last long at all.

The best part about fillers is that they begin taking effect immediately, so you will see a difference by the time you leave the office. The full effect takes about three days.

I noticed a change immediately and it was exactly what I had been looking for. However, I could feel the two spots where she had injected the gel. It was like two tiny lumps under the skin on my cheek, but they weren’t actually visible. I was a little worried about this at first but by the third day those bumps had settled and were no longer noticeable at all to the touch.

My experience with Botox is that there was no pain afterward. However, the Juvederm did leave my cheeks a little tender for about three-four days. I only really noticed it when touching my cheeks, so I avoided putting much pressure on the area until the gel had settled.

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THE RESULTS

Overall, I am very happy with the results from both the Botox and the Juvederm. My plan is to continue with the treatments as needed.

I still have some lines on my forehead, though they are not as deep or obvious. I may ask for a little more Botox the next time I go in, but I also might not. I do like that it still looks natural. I don’t want anything to be perfect, because nothing in nature is perfect, so some lines are expected.

If you are considering starting to use Botox or a filler, I recommend setting your expectations ahead of time. What are you looking to accomplish? Then be completely honest with your dermatologist to determine the best course of action.

Also, don’t use my experience or anyone else’s as a reason for you to get Botox. Just because it worked for me doesn’t mean you should get treatment for your forehead if you don’t actually have any issues with that area. Take a look in the mirror and determine the areas of your face that you would like to see smoothed. Once you have determined your own needs that is when you should meet with a dermatologist for a consult.

I know this is a lot of information to digest, especially if you are new to these treatments. But if you have any additional questions or want to share your own experiences let me know in the comments below!